Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.03 / $308.11 / $392.10	Facility	26	$133.03	$308.11	$392.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $472.57 / $1,867.74	Professional		$300.00	$472.57	$1,867.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.98 / $116.27 / $301.41	Professional	26	$82.98	$116.27	$301.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.84 / $318.33 / $1,206.68	Professional	TC	$168.84	$318.33	$1,206.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.60 / $890.02 / $1,113.74	Professional		$278.60	$890.02	$1,113.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.36 / $204.83 / $254.31	Professional	26	$87.36	$204.83	$254.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.24 / $635.72 / $872.39	Professional	TC	$191.24	$635.72	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.23 / $687.29 / $1,072.99	Professional		$390.23	$687.29	$1,072.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.59 / $125.71 / $227.46	Professional	26	$75.59	$125.71	$227.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $282.10 / $548.04 / $824.57	Professional	TC	$282.10	$548.04	$824.57
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $314.83 / $619.85 / $787.09	Professional		$314.83	$619.85	$787.09
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $94.50 / $98.18 / $178.62	Professional	26	$94.50	$98.18	$178.62
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $209.61 / $260.94 / $446.31	Professional	TC	$209.61	$260.94	$446.31
Health New England Facility/Professional Professional Modifier Low / Median / High Price $133.62 / $223.63 / $453.78	Professional		$133.62	$223.63	$453.78
United Facility/Professional Professional Modifier Low / Median / High Price $293.22 / $525.99 / $902.73	Professional		$293.22	$525.99	$902.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.37 / $130.36 / $266.56	Professional	26	$82.37	$130.36	$266.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.11 / $376.73 / $649.71	Professional	TC	$196.11	$376.73	$649.71